老年医疗保险受益人使用2015年Beers标准药物。

Rajul Patel, Leona Zhu, Dilraj Sohal, Elena Lenkova, Nichole Koshki, Joseph Woelfel, Carly Ranson, Cynthia S Valle-Oseguera, Edward L Rogan
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引用次数: 23

摘要

目的:根据2015年更新的美国老年医学会比尔斯标准,研究社区医疗保险受益人中潜在不适当药物(PIMs)的患病率。设计:横断面研究。背景:2015年秋季,13个流动医疗保险诊所在加州北部和中部举行。患者、参与者:65岁及以上服用一种或多种药物的非机构医疗保险受益人。干预措施:药学学生在执业药师的直接监督下进行药物治疗管理(MTM)。药物和疾病状态数据被收集并用于根据2015年Beers标准识别pim。主要结果衡量指标:正在接受PIM的受益人人数,有潜在的药物-药物或药物-疾病相互作用,以及与接受PIM有关的共同因素。结果:703名65岁及以上且服用1种及以上药物的受益人获得MTM服务。总共有204名(29%)受益人正在服用一种或多种PIM。54名受益人发现药物-药物相互作用,12名受益人发现有明显的药物-疾病相互作用。PIM处方与某些慢性疾病(如疼痛和失眠)有关。PIM使用率在女性中明显高于男性,在白人中明显高于非白人,在低收入受益人中明显高于高收入受益人。结论:开处方者和药剂师应共同努力,尽量减少老年人PIM的使用。了解2015年更新的比尔斯标准的从业者可以更密切地监测药物使用,希望最大限度地减少潜在的有害药物和/或疾病状态问题,并预防可避免的健康相关后遗症。
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Use of 2015 Beers Criteria Medications by Older Medicare Beneficiaries.

Objective: To examine the prevalence of potentially inappropriate medications (PIMs) in community-dwelling Medicare beneficiaries based on the updated 2015 American Geriatrics Society Beers criteria.

Design: Cross-sectional study.

Setting: Thirteen mobile Medicare clinics were held throughout Northern and Central California during the fall of 2015.

Patients, participants: Noninstitutionalized Medicare beneficiaries 65 years of age and older taking one or more medications.

Interventions: Pharmacy students under direct supervision of licensed pharmacists performed medication therapy management (MTM). Drug and disease state data were collected and used to identify PIMs based on the 2015 Beers criteria.

Main outcome measures: Number of beneficiaries who are taking a PIM, have a potential drug-drug or drug-disease interaction, and common factors associated with receiving a PIM.

Results: MTM services were provided to 703 beneficiaries 65 years of age or older taking 1 or more medications. In total, 204 (29%) beneficiaries were taking 1 or more PIM. Drug-drug interactions were found in 54 beneficiaries, and 12 beneficiaries were found to have a significant drug-disease interaction. PIM prescribing was associated with certain chronic conditions (e.g., pain and insomnia). The prevalence of PIM use was significantly higher in women compared with men, whites compared with non-whites, and low-income beneficiaries compared with high income.

Conclusion: Prescribers and pharmacists should work in concert to minimize PIM use in older adults. Practitioners knowledgeable about the updated 2015 Beers criteria may monitor drug use more closely, hopefully minimizing potentially harmful drug and/or disease-state problems, and preventing avoidable health-related sequelae.

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来源期刊
CONSULTANT PHARMACIST
CONSULTANT PHARMACIST PHARMACOLOGY & PHARMACY-
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期刊介绍: Vision ... The Society"s long-term desire, aspiration, and core purpose. The vision of the American Society of Consultant Pharmacists is optimal medication management and improved health outcomes for all older persons. Mission ... The Society"s strategic position, focus, and reason for being. The American Society of Consultant Pharmacists empowers pharmacists to enhance quality of care for all older persons through the appropriate use of medication and the promotion of healthy aging.
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